Tuan Jayson, Solano Miguel A, Fitzpatrick Noel
Fitzpatrick Referrals, Eashing, Godalming, Surrey, United Kingdom.
Vet Surg. 2019 May;48(4):607-614. doi: 10.1111/vsu.13189. Epub 2019 Mar 3.
To report the combined use of novel and commercially available implants for ventral distraction-stabilization of 5 continuous compressive sites in a Great Dane with cervical spondylomyelopathy (CSM).
Case report.
One 4-year-old male Great Dane weighing 78 kg.
A tetraparetic 4-year-old Great Dane with osseous-associated CSM (OA-CSM) with 5 sites of dorsolateral compression was presented for surgical intervention. Custom designed Fitz intervertebral traction screws (FITS) and a commercially available polyaxial spinal system were used for ventral distraction-stabilization of all lesions. Multiple neurological reevaluations were performed, with the final evaluation at 27 months postoperatively. Preoperative, immediate-postoperative, and 27 month-postoperative computed tomography (CT) images were retrospectively reviewed to compare the vertebral canal dimensions at the affected sites.
Multilevel distraction-stabilization technique resulted in improvement of the dog's neurological function by 10 days postoperatively. The vertebral canal measurements were revealed to have improved in over half of the measured variables when the 27-month-postoperative images were compared with the preoperative CT images. Increased vertebral canal dimensions were observed immediately after surgery, and some of these measurements continued to improve by 27 months postoperatively.
Ventral distraction-stabilization technique with custom-designed FITS and a polyaxial spinal system resulted in both clinical improvement and objective improvement in spinal canal measurements in an OA-CSM-affected Great Dane.
An indirect decompression technique can eliminate dynamic movements and result in regression of vertebral canal bony proliferation in dogs with OA-CSM.
报告联合使用新型植入物和市售植入物对一只患有颈椎病(CSM)的大丹犬的5个连续受压部位进行腹侧撑开固定。
病例报告。
一只4岁雄性大丹犬,体重78千克。
一只患有骨相关性CSM(OA-CSM)且有5个背外侧受压部位的四肢轻瘫4岁大丹犬接受手术干预。使用定制设计的菲茨椎间牵引螺钉(FITS)和市售多轴脊柱系统对所有病变进行腹侧撑开固定。进行了多次神经功能重新评估,术后27个月进行最终评估。回顾性分析术前、术后即刻和术后27个月的计算机断层扫描(CT)图像,以比较患部椎管尺寸。
多级撑开固定技术使犬的神经功能在术后10天得到改善。将术后27个月的图像与术前CT图像比较时,超过一半的测量变量显示椎管测量值有所改善。术后即刻观察到椎管尺寸增加,其中一些测量值在术后27个月持续改善。
采用定制设计的FITS和多轴脊柱系统进行腹侧撑开固定技术,使一只受OA-CSM影响的大丹犬在临床和椎管测量方面均有改善。
间接减压技术可消除动态运动,并使患OA-CSM的犬的椎管骨质增生消退。